Robert Linkul: The Phobias of Training Older Adults

Upon entering the profession, most personal trainers desire to work with highly competitive and aspiring athletes. Then, they open their schedule and start taking on clients, most of whom tend to come from the demographic of general health and fitness-based populations (not competitive athletes).

A large portion of the general health and fitness demographic is the special population of “older adults.” The older adult demographic, comprised of individuals 50-80 years of age, is in desperate need of professional guidance and direction as they tend to disproportionally suffer from physical limitations and pain management issues.

Despite being a large population, and one that also has a great need, most personal trainers do not pursue working with older adults for three reasons.

1. Trainers Don’t Know How to Assess The Movement of Older Adults

In an industry full of different assessment strategies, tools and protocols, the uneducated and/or inexperienced personal trainer may not possess the skillset to safely assess the older adult. Typical assessments can include exercises and movement patterns like the push up, the overhead squat or the in-line lunge. When implemented safely and correctly, these movements are perfectly fine for the healthy older adult client to perform, but for the older adult dealing with one or more physical limitations (sciatica, shoulder impingement, torn meniscus, etc.) or pain management issues, these exercises can be unsafe and/or difficult for the untrained or undertrained older adult to perform.

A large majority of older adults have at least one physical limitation and that limitation is often the reason for them seeking out the assistance of a fitness professional. It’s the personal trainer’s professional responsibility to “do no harm” with every client with whom they have the pleasure of working and the older adult is no different. If the client indicates the presence of a physical limitation that will not allow them to safely perform movement assessment exercises, then a movement observation assessment may be a more appropriate option.

Movement observation assessments can include rating or scoring a client’s ability to perform basic movements of daily life, like reaching overhead, sit-to-stand, stepping down and up or getting up and down off the floor, just to name a few. These daily life movements are typically performed by all clients on a regular basis however, the skill to perform these movements may vary from person to person. Based on these basic daily life movements and the client’s ability to perform them efficiently the personal trainer can design an appropriate program to address their specific needs.

Eventually, improved efforts in their programming may result in the client being able to perform some or all of the more common exercise-based movement assessments.

2. Trainers are Afraid of Hurting Older Adults

A common misconception is that the older or aging adult is fragile and incapable of performing moderate to advance exercises or highly challenging workouts. This misconception comes from the idea that most people over age 50 inevitably have some sort of physical limitation that they personal trainer needs to fix or work around.

Common limitations could include a lower back, hip, knee or shoulder issue or a physical disease like arthritis, neuropathy or cancer.

Contrary to this belief, the majority of older adults are very capable of training hard and pushing themselves to higher levels . . . despite a physical limitation. They may simply need to progress through a training program to reach these levels. A large portion of physical limitations that older adults may have can be improved with the introduction of a basic strength and conditioning program implemented two to three days per week.

With limited or no experience training clients with physical limitations, some personal trainers will attempt to “work around” the client’s issue. This act has two outcomes, both negative:
First, it does not improve the client’s physical limitation. The client’s body will learn to compensate with other musculatures, often leading to more injury. Second, they will improve in all other areas creating a bigger gap between the physical limitation and the rest of the body’s ability to operate. Although improvements have been made, the goal of improving the entire body has become even more difficult as one operating component has been left behind.

To the uneducated and/or inexperienced fitness professional the aforementioned limitations may be outside their knowledge base. Though the scope of practice for the personal trainer does not include prescribing physical therapy, they are capable and able to implement exercises prescribed by a physical therapist that are specific to the client and their limitations. Clients with a limitation may be asked to go to physical therapy first to fix their limitation, as this issue is not in an area of expertise for the personal trainer.

Typically, the client will go to physical therapy until they are cleared to participate in regular activity. In many cases, the limitation can be rehabilitated at the same time as the pursuit of regular health and fitness-based goals. The personal trainer can partner with a physical therapist or coordinate with the client’s current physical therapist as to what exercises they could implement, progress and/or avoid in their daily programming.

Developing a partnership or coordinating with a physical therapist has multiple benefits: It provides the personal trainer direction on how to progress their client toward correctly improving their physical limitations. It also provides the trainer the knowledge and experience to apply as they move forward with future clients. While this does NOT mean that the personal trainer will be capable or able to prescribe physical therapy to future clients, it does provide the trainer the confidence in having done so successfully with a previous client or clients who have the same or similar limitations.

3. Trainers Don’t Know How to Appropriately Progress Older Adults

Many older adults have yet to find their way into a weight room or to participate in any form of physical activity. While generally more fit as youth than the current population, the baby boomer generation did not have the information on the importance of physical fitness that the generations of today have. Lacking a focus on life-long fitness, the older adult my not have the neuromuscular facilitation (ability to coordinate muscle movement smoothly or efficiently) required to perform even the most basic strength and conditioning movements. This does NOT mean the older adult cannot perform these movements; it does mean they will need a safe, progressive and efficient program design with proper cueing to teach them.

Personal trainers can develop a training philosophy that outlines their programming components (push, pull, press, squat, carry, etc.) and the exercise progressions of each. This progression would start with the most-simple (basic) movements like a bridge, strict press, plank and step up to the most complex (advanced) movements like a clean, snatch, get up or box jump.

Due to the average older adult’s lack of physical activity and/or strength and conditioning experience the uneducated and/or inexperienced personal trainer may be intimidated or find it very difficult to work with older adults. Patience, a well-founded training philosophy and proper exercise progression could drastically help keep the client on track.

The obstacle of teaching from such a basic level provides two valuable opportunities for the personal trainer.

First, it provides a wonderful learning experience for the personal trainer to truly have a positive effect on a client’s life. Assisting and helping them improve their ability to move more efficiently, safely and athletically can greatly improve the client’s quality of life. For those suffering from major physical limitations, disease or pain management, this achievement should not be taken lightly, as this can be a life-changing experience for clients who need your help the most.

Second, it allows the personal trainer to work on their ability to progress and teach their programming. This is an opportunity to practice and work toward mastering their skills needed to work with individuals of all levels. Those who struggle to perform even the most-simple movements are the ones who need the personal trainer’s assistance, guidance and direction the most.

In an industry where the majority of new business generation comes from referrals (estimated at 90-plus %) personal success stories and experiences will do wonders for future client recruitment. The more efficient a personal trainer can be teaching proper movement mechanics and improving a client’s quality of life by achieving their fitness based goals, the more successful they will be in this competitive industry.

Getting Started Training Older Adults

When it comes to training goals, the older adult typically wants to focus on improving their quality of life through better movement patterns and decreased pain. Often, these are not the most challenging components for the personal trainer to develop a program to improve.

There is a great sense of accomplishment and pride for the personal trainer when they see the program that they created come to fruition and, as a result, observe their client walk without the use of their cane for the first time in a decade or successfully get up and down off the floor post hip replacement.

Learning to properly assess, progress and cue the older adult client will help them achieve their goals, reduce their risk of injury and improve their overall quality of life.

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